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Medicare Risk Adjustment Chart Review Jobs (NOW HIRING)

Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... The manager will oversee retrospective and prospective chart review programs while supervising the ...

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Village Care

Risk Adjustment Coding Manager

Manhattan, NY · On-site

$102K - $115K/yr

Medicare Risk Adjustment Coding Manager Location: Remote (Must Reside in NY/NJ/CT) Work Schedule ... The manager will oversee retrospective and prospective chart review programs while supervising the ...

Community Health Choice

Risk Adjustment Coder II

Houston, TX · On-site

$18 - $23.75/hr

... Medicare risk adjustment programs. Conduct thorough clinical documentation review to ensure ... sufficient support and management for coded conditions. 25% Identify opportunities to improve ...

Harris Health System

Risk Adjustment Coder II

Houston, TX · On-site

$27.69 - $34.61/hr

... Medicare risk adjustment programs. Conduct thorough clinical documentation review to ensure sufficient support and management for coded conditions. Identify opportunities to improve documentation and ...

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All JobsMedicare Risk Adjustment Chart Review Jobs

Medicare Risk Adjustment Chart Review information

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$18

$43

$79

How much do medicare risk adjustment chart review jobs pay per hour?

As of Jul 1, 2026, the average hourly pay for medicare risk adjustment chart review in the United States is $43.31, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $53.12 per hour, depending on experience, location, and employer.

What are some common challenges faced in a Medicare Risk Adjustment Chart Review role, and how can they be managed?

A common challenge in Medicare Risk Adjustment Chart Review is ensuring the accuracy and completeness of medical documentation to support proper coding and risk adjustment. Reviewers often encounter incomplete records or ambiguous provider notes, which requires strong attention to detail and effective communication with healthcare staff to clarify information. Staying current with CMS guidelines and coding updates is essential, as regulations and requirements can change frequently. Proactively collaborating with providers and participating in regular training sessions can help manage these challenges and improve review quality.

What is Medicare Risk Adjustment Chart Review?

Medicare Risk Adjustment Chart Review is a process where healthcare professionals review patient medical records to identify and validate diagnoses that impact Medicare Advantage risk scores. This ensures that Medicare Advantage plans receive accurate reimbursement based on the health status and complexity of their enrollees. The review helps to capture any conditions that may not have been coded during patient visits, improving data accuracy and compliance with CMS regulations.

What is the difference between Medicare Risk Adjustment Chart Review vs Medical Coder?

AspectMedicare Risk Adjustment Chart ReviewMedical Coder
Primary FocusReviewing patient charts to ensure accurate risk adjustment data for MedicareAssigning medical codes based on clinical documentation for billing and records
CertificationsOften requires coding certifications and knowledge of Medicare guidelinesCertified Professional Coder (CPC) or equivalent
Work EnvironmentHealthcare facilities, insurance companies, or remoteHospitals, clinics, or billing companies
Industry UsageMedicare Advantage plans, risk adjustment programsMedical billing, coding, and documentation

While both roles involve medical documentation, Medicare Risk Adjustment Chart Review focuses on analyzing charts to optimize Medicare risk scores, whereas Medical Coders assign codes for billing purposes. Understanding these differences helps in choosing the right career path or job focus within healthcare documentation and billing.

What are the key skills and qualifications needed to thrive as a Medicare Risk Adjustment Chart Reviewer, and why are they important?

To thrive as a Medicare Risk Adjustment Chart Reviewer, you need a solid understanding of medical coding (CPT, ICD-10), healthcare compliance, and clinical documentation, often supported by a coding certification such as CPC, CRC, or CCS. Familiarity with electronic medical records (EMRs), risk adjustment software, and auditing tools is typically required. Attention to detail, analytical thinking, and strong communication skills set top performers apart in accurately interpreting and reporting clinical data. These competencies are crucial for ensuring accurate risk adjustment, regulatory compliance, and optimized reimbursement for healthcare organizations.
More about Medicare Risk Adjustment Chart Review jobs
What cities are hiring for Medicare Risk Adjustment Chart Review jobs? Cities with the most Medicare Risk Adjustment Chart Review job openings:
What states have the most Medicare Risk Adjustment Chart Review jobs? States with the most job openings for Medicare Risk Adjustment Chart Review jobs include:
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Medicare Risk Adjustment Chart Review jobs near you
Infographic showing various Medicare Risk Adjustment Chart Review job openings in the United States as of June 2026, with employment types broken down into 1% Internship, 46% Full Time, 49% Part Time, and 4% Contract. Highlights an 90% Physical, 2% Hybrid, and 8% Remote job distribution, with an average salary of $90,079 per year, or $43.3 per hour.
Medicare Risk Adjustment Specialist I

Medicare Risk Adjustment Specialist I

On Belay Health Solutions

Remote

$25 - $28/hr

Full-time

PTO

This job post has expired today. Applications are no longer accepted.

Job description

About On Belay Health Solutions
On Belay Health Solutions is a Massachusetts-based physician-led managed services organization (MSO) devoted to supporting independent primary care physicians. On Belay provides enhanced Medicare value-based contracts that empower physicians with the resources necessary to invest in innovative care models and population health management tools. This allows physicians to practice medicine and positively impact the health of their communities in the way they have always dreamed.
About the role
We are seeking a detail-oriented Medicare Risk Adjustment Coding Specialist to support our innovative AI-driven chart review and risk adjustment programs. This role differs from a traditional retrospective chart review position. Rather than conducting full manual chart reviews, the specialist will work alongside advanced AI technology to validate, refine, and support coding opportunities identified through automated chart analysis.
The ideal candidate will possess strong knowledge of Medicare Advantage risk adjustment methodologies, HCC coding, and clinical documentation requirements, while demonstrating the ability to evaluate AI-generated coding recommendations and ensure accuracy, compliance, and coding integrity.
This is a Full-Time role with expectation for 40 hours per week. We look forward to meeting interested applicants and mutually assessing fit in joining On Belay on our important mission to transform healthcare!
What you'll do
  • Review and validate AI-identified risk adjustment coding opportunities within medical records.
  • Assess clinical documentation to determine the appropriateness of proposed diagnoses and HCC submissions.
  • Support the quality assurance process for AI-assisted chart reviews by identifying coding discrepancies, false positives, and missed opportunities.
  • Develop feedback loop with On Belay's Head of Risk Adjustment Coding and physician offices On Belay supports, including but not limited to:
    • Identification of quality improvement opportunities in individual physician coding
  • Any other related duties assigned at manager's discretion

Qualifications
  • High school diploma or GED required. Associates degree preferred.
  • Active coding certificate required. AAPC or AHIMA coding certification preferred.
    • Required: CCS-P (Certified Coding Specialist- Physicianbased) or CPC (Certified Professional Coder)
    • Preferred: CRC (Certified Risk Adjustment Coder)
  • Experience in a primary care setting highly preferred.
  • Knowledge of medical terminology and medical chart review required. Two (2) or more years' experience of hierarchical condition categories (HCC)
  • Knowledge of ICD-10-CM Official Guidelines for Coding and Reporting
  • Knowledge of AHA Coding Clinic and authoritative coding resources
  • Knowledge of Microsoft Office suite, primarily Excel (specifically Pivot Tables, sort and filter functions)
  • Strong time management skills required
  • Ability to navigate within various EMRs (Electronic Medical Records), Cerner Preferred
  • Strong interpersonal, communication (verbal, non-verbal and listening) skills
  • Ability to remain productive under time constraints and meet deadlines critical to the business

Benefits
  • Innovative, revolutionary environment
  • Great culture with a strong sense of mission and community
  • Eleven (11) Paid Holidays
  • Lavish PTO accrual
  • Advancement opportunities & professional skills training
  • Strong referral bonus program
  • And more!

Compensation
  • We offer a competitive base salary ranging from $25 - $28 per hour.

Come join us on the journey to better and more affordable healthcare!
We are an equal opportunity employer. Employment selection and related decisions are made without regard to age, race, color, national origin, religion, sex, disability, sexual orientation, gender identification, or being a qualified disabled veteran or qualified veteran of the Vietnam era or any other category protected by Federal or State law.

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